Stigma Of Illness Research Articles

Factor structure and reliability of the Greek version of Attitudes Towards Mentally Ill Offenders (ΑΤΜΙΟ) Scale in a general population sample.

Mentally ill offenders constitute a group with a unique set of characteristics since they are doubly stigmatized by both their mental illness and the offence they have committed. The coexistence of these two circumstances significantly heightens negative public attitudes towards these people. The group of mentally ill offenders has been shown to elicit more stigmatic attitudes than offenders without a mental health condition. Nevertheless, research on stigma towards mentally ill offenders is rather limited, while the number of psychometric tools used to measure this stigma is even smaller compared to the number of relevant tools assessing mental illness stigma. The purpose of this study was to explore the attitudes towards mentally ill offenders in a Greek sample in terms of demographic characteristics, and at the same time to assess the psychometric properties of a specialized tool on stigma towards this patient group, namely the Attitudes Towards Mentally Ill Offenders (ΑΤΜΙΟ) scale in Greek. The study included 1031 participants from the general population who completed an online questionnaire on sociodemographic data as well as the ATMIO scale. The scale's structural validity was tested on the basis of the exploratory factor analysis after Quartimax rotation, and the internal relevance of its factors recorded a Cronbach's alpha value of more than 0.7, both for the whole scale and its individual factors. It was shown that more negative stereotypes towards mentally ill offenders were correlated with less compassion and less desire for their rehabilitation, with stronger belief and conviction that they represent a danger to the community, with less diminished responsibility, and a lot fewer positive attitudes in general. Women, older people, individuals with a lower education level and participants with children were found to hold more negative attitudes. The ATMIO scale translated in Greek is the first tool to measure attitudes towards mentally ill offenders in the country and shows satisfactory internal consistency and interpretation of its four-factor structure. It is a comprehensible and easy-to-complete scale, which can become a reliable tool to record attitudes towards mentally ill offenders also in our country.

Precision medicine: how to approach the adolescent asthmatic

It is well known that adolescent patients often have less than optimal outcomes. Adolescence is a time of much transition, physically, emotionally, and socially all of which have effects on asthma management and outcomes. Pubertal changes affect asthma, but mostly it is the move towards independence from the parents, peer pressures, stigma of illness, and adherence issues that cause the issue. It is thus important to learn to treat the patient directly, wherein currently often children are treated through the parent, to ensure success.

Stigma Toward Substance Dependence: Causes, Consequences, and Potential Interventions

Substance dependence is a prevalent and urgent public health problem. In 2021, 60 million Americans reported abusing alcohol within the month prior to being surveyed, and nearly 20 million Americans reported using illegal drugs (e.g., heroin) or prescription drugs (e.g., opioids) for nonmedical reasons in the year before. Drug-involved overdose rates have been steadily increasing over the past 20 years. This increase has been primarily driven by opioid and stimulant use. Despite its prevalence, drug dependence is one of the most stigmatized health conditions. Stigma has myriad negative consequences for its targets, including limiting their access to employment and housing, disrupting interpersonal relationships, harming physical and mental health, and reducing help-seeking. However, because research on stigma toward people with substance use disorders (SUDs) is relatively sparse compared with research on stigma toward other mental illnesses, the field lacks a comprehensive understanding of the causes and consequences of SUD stigma. Moreover, it remains unclear how, if at all, these factors differ from other types of mental illness stigma. The goal of this review is to take stock of the literature on SUD stigma, providing a clear set of foundational principles and a blueprint for future research and translational activity.

Arabic validation of the "Mental Health Knowledge Schedule" and the "Reported and Intended Behavior Scale".

Mental illness affects one in eight people in the world according to the WHO. It is a leading cause of morbidity and a major public health problem. Stigma harms the quality of life of people with mental illness. This study aimed at validating the Arabic version of the Mental Health Knowledge Schedule (MAKS) and the Reported and Intended Behavior Scale (RIBS) in a sample of Tunisian students and determining socio-demographic and clinical factors correlated with stigma. This cross-sectional study was conducted on 2,501 Tunisian students who filled in the MAKS, the RIBS, and a sociodemographic and clinical questionnaire. The validation of the questionnaires in Arabic was carried out using the validity criteria: face and content validity, reliability, and construct validity. Next, the associations between stigma and sample characteristics have been studied using multivariate linear regression. Face and content validity of the measures MAKS and RIBS were satisfactory, with adequate internal consistency. There were significant positive correlations between the items and scales, and test-retest reliability was excellent. The internal validity showed that the items were well-aligned with the intended factors, and the external validity revealed a significant positive relationship between the MAKS and RIBS. Besides, gender, the field of study, psychiatric history, and contact with someone with a mental illness were all contributing factors to mental illness stigma. Additionally, men performed better than women in terms of behavior toward people with mental illness, while women had a greater level of knowledge about mental health. The Arabic versions of the MAKS and RIBS have appropriate psychometric properties, making them effective tools for evaluating mental illness stigma. With multiple factors contributing to this issue, these instruments can help focus anti-stigma efforts and promote a more inclusive society.

Well-being, turnover intention, and stigma attitudes of mental health transition-to-practice nurses: A cross-sectional study.

There is global recognition that mental health nursing can be stressful and have detrimental effects on nurses' well-being and retention. With substantial nursing shortages, there is an urgent need to attract and retain nurses to sustain this workforce and provide effective mental healthcare. Mental health transition programs provide vital recruitment pathways and support novice registered nurses, enrolled nurses and experienced registered generalist nurses moving into this field. There is little evidence, however, on the well-being, resilience, and retention of nurses transitioning into mental health. The primary aims for this cross-sectional study were to describe demographic characteristics, perceived stress, well-being, resilience, mental illness stigma attitudes, work satisfaction, and turnover intention of four nurse cohorts entering mental health transition programs: generalist registered nurses, graduate and post-graduate registered nurses, and enrolled nurses; to explore relationships between these variables; and explore differences between these four nurse cohorts. Findings (n = 87) included overall moderate perceived stress, moderate well-being and resilience, high work satisfaction, low stigma, and low turnover intention. Higher turnover intention was associated with lower age and work satisfaction, and higher perceived stress. Generalist RNs had significantly higher stress and stigmatizing attitudes than Enrolled Nurses. Secondary analysis of well-being scores identified 14 nurses with scores indicating depression, with significantly lower resilience and work satisfaction, and significantly higher stress than the rest of the sample. To help prevent attrition, it is vital that mental health services provide tailored well-being initiatives during transition and intervene early to provide support for nurses with mental distress.

Transcultural Validity of Concept of Internalized Stigma in Patients with Mental Illnesses (Psychometric Properties of Russian Version of Internalized Stigma of Mental Illness Scale)

INTRODUCTION: One of the commonest methods of evaluation of internalized stigma is Internalized Stigma of Mental Illness (ISMI) scale where the differences in the prevalence and perception of mental stigma in different cultures are specified.
 AIM: Validation of Russian version of ISMI scale and evaluation of peculiarities of perception of stigma by Russian-speaking patients with severe psychiatric disorders.
 MATERIALS AND METHODS: Four hundred thirty nine patients with severe psychiatric disorders (F2 and F3 according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision) were examined. The psychometric properties of the Russian version of ISMI scale were evaluated using internal consistency analysis. Exploratory and confirmatory factor analysis (EFA and CFA, respectively) were performed. To check age- and gender-related invariance, MIMIC and MIFA models were used, and discriminative power and accuracy of scoring were identified using generalized partial credit model (GPCM). The results of EFA were compared with the data obtained in the Regional Clinical Hospital (n = 120) using independent alternative version of ISMI translation into Russian.
 RESULTS: The internal consistency of the Russian version of ISMI questionnaire was high: Chronbachs 0.90. EFA permitted to identify 4 factors. The first factor (Demoralization, F1) combined elements corresponding to subscale 1 (Alienation) and subscale 2 (Social withdrawal) of the original version of ISMI questionnaire. The other three factors identified in this study according to the content of the items, corresponded to the remaining subscales of the original ISMI scale. In all kinds of the conducted analysis, item 14 had low factor weight. CFA confirmed the four-factor structure. In the sample, MIMIC and MIFA showed the general age- and gender-related invariance with their insufficient power. GPCM showed good characteristics of discriminative power and difficulties in choice of scoring for all factors except the fourth one (Resistance to stigma). EFA performed on the data of the alternative sample, neither could reliably reproduce the five-factor structure of the original ISMI scale due to eclectic mixing of the items of the original scale within five isolated structures.
 CONCLUSION: The suitability of using the internalized stigma assessment tool for the Russian-speaking population has been confirmed. The study highlights the relevance and necessity of expanding transcultural studies of psychological reactions of psychiatric patients.

Evaluating the effect of an adapted mental health literacy intervention on mental health related stigma among secondary students in Germany: results of a pre-post evaluation study

BackgroundMost mental health problems develop during youth, with about three quarter emerging before age 25. In adolescence, stigmatizing attitudes related to mental illness become more nuanced and consolidate into one’s belief system. As the stigma of mental illness is still one of the leading barriers to help-seeking, intervention measures should explicitly address it before it becomes entrenched over time. Preventive measures, for example, based on promoting mental health literacy (MHL), can be used to address and tackle stigmatizing attitudes. The Canadian MHL-based intervention “the Guide” was translated and adapted for the use in German schools. The present study evaluates the effect of the German version of the Guide on attitudes towards mental illness among students in Germany.MethodsThe first-time application of the Guide (German version) was evaluated with a pre-post-evaluation study with an intervention and a control group. The evaluation data of 188 students (intervention group n = 106, control group n = 82) were statistically analyzed focusing on the outcomes social stigma, social distance, and self-stigma.ResultsThe analysis showed that participants do not tend to hold stigmatizing attitudes even before the intervention. Nevertheless, the intervention was effective in reducing social stigma, but not in reducing social distance and self-stigma. Neither gender, pre-existing experience with mental illness, nor the delivery modality of the contact element within the intervention (speaker vs. video) seemed to influence the outcomes.ConclusionsThe German version of the MHL-based intervention, the Guide, seems to be a suitable intervention to improve attitudes towards mental illness among students in Germany. More extensive research is necessary to confirm the findings and further explore factors that influence the program’s effects on attitudes short- and long-term.

Concrete or Abstract? The Effects of Picture Concreteness and Mental Illness Prevalence on Destigmatizing Mental Illnesses

This study investigated how picture concreteness (cartoon versus photo) and mental illness prevalence level (high versus low) in mental health messages influence mental illness stigma via a within-subjects online experiment (N = 92). Findings revealed that, compared to cartoons, photos elicited greater empathic closeness, decreased social distancing intention (especially for the low-prevalence mental illnesses of schizophrenia and bipolar disorder), and increased intention to support mental health policies. Compared to photos, cartoons increased comprehension (especially for the high-prevalence mental illnesses of depression and anxiety) and reduced personal responsibility for mental illness. Messages about high-prevalence mental illnesses compared to low-prevalence mental illnesses elicited more empathic closeness, lower social distancing intention, and higher message dissemination intention.

Mass Media Target Audience and Mental Illness Stigmatization among Students of Kenya Medical Training College

Mass media plays a fundamental role in influencing the society and their perceptions in daily life. The target audience by the media determines the how they frame their message and the subject matter that they focus on in their discussions. As mental illness is becoming one of the contemporary issues in the modern society, the role of mass media particularly how they define their target audience is not adequately explored. This is despite mental illness continuing to ravage the society, especially with the increased stigmatization. This study therefore sought to examine the how mass media target audience impact mental illness stigmatization in among students in Kenya Medical Training College. The study was anchored on the cognitive dissonance theory. Using a descriptive research approach, the study through a questionnaire surveyed 384 students drawn from a population of 51045 students at the college. The data was analysed using descriptive and inferential statistics through SPSS. The findings revealed that mass media target audience through the reduced dissonance, acquisition of new information and cognitive actions significantly impacted the mental illness stigmatization. Through the beliefs towards the mentally ill persons as projected by the mass media to their target audience, the stigmatization of mentally ill persons either increased or decreased depending on the approach used by the mass media. The study concluded that mass media target audience was instrumental in determining the level of stigmatization of the mentally ill persons. It is therefore recommended that the mass media should define their target audience in a manner that positively changes their perceptions towards mental illness.

HELP SEEKING ATTITUDES FOR MENTAL ILLNESSES AMONG UNDER-GRADUATE MEDICAL STUDENTS IN LAHORE

Objective: The reluctance of medical students to seek help for stress is attributed to a lot of factors involving stigma, their help-seeking attitudes and psychological openness. The objective of this study is to gauge help seeking attitudes for stress and mental health issues among Pakistani medical students. Design: Two questionnaires were used to form a self-administered questionnaire, including Hopkins Symptom Checklist (SCL-5) and Inventory of Attitudes towards Seeking Mental Health Services (IASMHS). Place & duration of study: Students from King Edward Medical University, Lahore and Fatima Memorial Hospital were administered the questionnaire in physical form as well as an online version. Responses were gathered over a time of 3 months. Methods: We conducted a cross-sectional survey in two selected medical colleges in Lahore in 2022. After IRB approval and informed consent, a self-administered questionnaire which included Hopkins Symptom Checklist (SCL-5) and Inventory of Attitudes towards Seeking Mental Health Services (IASMHS) was utilized for data collection. Analysis was conducted with SPSS 26. Results: Six hundred and forty-one undergraduate medical students participated in the study with majority being female (64.2%) and hostellers (59%). SCL- 5 scores of the participants (mean=13.36, S. D=4.95) showed moderate levels of distress among students. Participants’ mean Attitude Score on IASMHS was 53.66 (S. D=10.72). Attitudes towards help seeking were fairly negative especially with regard to feeling indifferent towards stigma (mean=18.95, S.D=5.69). Student’s attitudes reflected some psychological openness (mean=14.48, S.D=5.35), while propensity to seek help was slightly better (mean=20.23, S.D = 4.75). Females and clinical year students showed more positive attitudes towards help seeking as compared to males and students belonging to pre-clinical years (P<0.05). Conclusion: The study showed that stress among under-graduate medical students remains a significant issue. While female students and clinical years’ students portrayed better help seeking attitudes towards mental illnesses and stress, further studies including interventions to address mental illness stigma are required to improve the trend.

Stereotypes and OCD-Symptom Presentations: A Mixed-Methods Evaluation Using Male-Character Vignettes

Stereotypes toward symptom presentations of obsessive compulsive disorder (OCD) are poorly understood. A mixed-methods, multistudy analysis of OCD stigma was conducted. In Study 1 ( N = 60), participants read one of five vignettes (symmetry/just right, contamination, sexual, harm/aggression, scrupulous OCD) before responding to open-ended questions. Inductive content analyses revealed anxiety-relevant stereotypes (e.g., trivialization) for symmetry/just right and contamination and serious mental-illness stereotypes (e.g., dangerous) for harm/aggression and sexual vignettes. In Study 2 ( N = 698), participants read one of seven vignettes (OCD-symptom presentations, generalized anxiety disorder, schizophrenia) before responding to stigma measures. The sexual, harm/aggression, and schizophrenia vignettes were strongly associated with serious mental-illness stigma. The scrupulous vignette was associated with the most anxiety-relevant stigma. Together, these studies detail stereotype endorsement across OCD-symptom presentations. Stigma-reduction interventions should include psychoeducation and address macro-level stereotypes (i.e., stereotypes that exist across symptom presentations) while enhancing opportunities for contact to mitigate stigma.

When psychiatry encounters local knowledge of madness: Ethnographic observations in a Chinese psychiatric hospital

As the number of psychiatric hospitals are on the rise in China, this article examines how the psychiatric discourse as articulated by hospital staff interacts with local cultural understandings of madness/mental illness, as well as how such interactions impact patients and families’ reception of psychiatry. Data comes from 16 months of fieldwork in a psychiatric hospital in South China. We show that psychiatric professionals at the hospital attempted to establish their professional authority by discrediting other cultural epistemologies embraced by patients or families, such as religious and traditional Chinese medical understandings. Despite the quick effect of psychopharmaceuticals to control symptoms, the psychiatric perspective ultimately fell short in addressing the social and moral struggles faced by patients, such as patriarchy and gender-based violence. Moreover, as psychiatric professionals unreflexively used certain problematic local concepts to convey a biomedical and even genetically-determined account of mental illness to patients and families, they risked entrenching the stigma of mental illness and disempowering their clients. To improve the quality of mental healthcare, to make clients feel culturally safe and respected in clinical encounters, psychiatric professionals in China should develop a more holistic approach that takes into account the biological, psychological, and sociocultural aspects of mental illness, that recognizes the diverse sources of help clients may rely on. They should also develop a critical awareness of the language they use and of the power dynamics in which they and their clients are situated.

Humanised care in acute psychiatric hospitalisation units: Definition, values and strategic initiatives from the perspective of persons with mental health problems, primary carers and professionals.

Humanised care refers to the holistic approach to the person, considering their bio-psycho-social and behavioural dimensions. It becomes more complex when the person has mental health problems that may affect his or her will, cognition and relationship to the world. The literature on the humanisation of mental health is scarce and only offers the view of professionals. To analyse the concept, values and strategic initiatives of humanised care in acute psychiatric units from the perspective of persons with mental health problems, carers and professionals. Qualitative grounded-theory approach. Data were collected through focus groups and in-depth interviews among persons with mental health problems, carers and professionals. Thirteen focus groups and three in-depth staff interviews were performed, with a total of 61 participants. Humanised care is defined as quality care of an individualised, ethical and safe nature, empowering persons/carers to involve them in their health process, helping them resist the stigma of mental illness through a therapeutic relationship, bond and communication. Formal training, teamwork and effective communication are required. Six values and strategic initiatives were identified. Each value and strategic initiatives acquires full meaning when connected with the rest. Without this interconnection, humanised care would be impossible.

Childhood trauma and self-stigma in mood disorders

Childhood maltreatment and mood disorders are associated and linked to self-stigma. In this study, we assessed the relationship between childhood trauma and self-stigma in patients with mood disorders. Patients with bipolar disorder (n ​= ​69) and unipolar disorder (n ​= ​111) were recruited from the Mood Disorders Unit of the Geneva University Hospitals in Switzerland. All participants underwent a semi-structured interview to assess mood disorder and fulfilled the Internalized Stigma of Mental Illness (ISMI) scale and the Childhood Trauma Questionnaire (CTQ). The results showed that overall self-stigma was not significantly different between the groups. Linear regression modeling revealed that the ISMI total score was significantly associated with the CTQ total score (estimate ​= ​0.01, p ​= ​0.045). Our findings support the assumption that childhood trauma promotes the development of self-stigma in patients with mood disorders. Therefore, this study underscores the importance of assessing childhood trauma in the management of self-stigma in patients with unipolar and bipolar disorder.

Fostering the community participation of individuals with psychiatric disabilities: Effectiveness of a new peer-led photovoice-based intervention.

Having meaningful social roles and full community participation have been examined as a central tenet of the recovery paradigm. We undertook this study to test a new multimodal, peer-led intervention, which we have developed with the aim of fostering the self-efficacy of individuals with psychiatric disabilities to pursue involvement in community activities of their choice. We evaluated the effectiveness of the 6-month manualized peer-delivered "Bridging Community Gaps Photovoice (BCGP)" program with a multisite randomized trial (N = 185), with recipients of services at five community mental health programs. Mixed-effects regression models were used to examine the impact of the program on community participation, loneliness, personal stigma, psychosocial functioning, and personal growth and recovery when compared to services as usual. Individuals who were randomized to the BCGP intervention were also invited to participate in exit focus groups, exploring the program's perceived active ingredients of mechanisms of impact. Participation in the BCGP program facilitated ongoing involvement in community activities and contributed to a decreased sense of alienation from other members of the community due to internalized stigma of mental illness. In addition, greater attendance of group BCGP sessions had a significant impact on participants' sense of self-efficacy in pursuing desired community activities. This study provided initial evidence about the promise of the BCGP program in enhancing community participation. Its implementation in community mental health agencies can further expand the recovery-oriented services provided to people with psychiatric disabilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

When mental health care is stigmatizing: A participative study in schizophrenia.

Mental health care has been identified as a major source of mental illness stigmatization. Detailed information about these stigmatization experiences is thus needed to reduce stigma in mental health practices. The study aimed to (a) identify the most relevant stigmatizing situations in mental health care encountered by users with schizophrenia and their families; (b) characterize the relative importance of these situations in terms of frequency, experienced stigmatization, and associated suffering; and (c) identify contextual and individual factors associated with these experiences. An online survey was conducted in France among users and family members to characterize situations of stigmatization in mental health care and identify associated factors. The survey content was first developed from a participative perspective, through a focus group including users. A total of 235 participants were included in the survey: 59 participants with schizophrenia diagnosis, 96 with other psychiatric diagnoses, and 80 family members. The results revealed 15 relevant situations with different levels of frequency, stigmatization, and suffering. Participants with a diagnosis of schizophrenia experienced more situations of stigmatization, with a higher frequency. Moreover, contextual factors were strongly associated with experienced stigmatization, including recovery-oriented practices (negatively associated) and measures without consent (positively associated). These situations, as well as associated contextual factors, could be targeted to reduce stigmatization and related suffering in mental health practices. Results strongly underscore the potential of recovery-oriented practice as an instrument to fight stigma in mental health care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Religion and Philosophy Affected Stigma against Mental Illness and Impact on the Mental Health Care in India and China

Mental illness has been a prevalent issue around the world however; an existing stigma against mental illness is preventing the development of proper mental health care and resources. This phenomenon is seen in the countries of India and China. Considering a stigma is developed within the society based on some beliefs upheld by the general population, it was in the best interest to investigate religions and philosophies that people in both China and India follow and uphold. This paper aims to answer the research question of “In what ways has religion and philosophy, specifically Islam, Hinduism, Buddhism, and Confucianism, affected stigma against mental illness and thus the available mental health care in India and China?”. Through research done on the four religions/philosophies, certain connections could be made. In India, Hinduism views mental illness as a result of a lack of faith and adherence to rituals. In Islam, mental illness is also believed to be due to a lack of faith. Such negative views of mental health could be contributing to the large treatment gap in India. In China, Confucianism seems to be the reason why a mental illness stigma exists. Confucianism emphasizes adherence to societal views, even if that means suppressing emotion. This causes people to look down upon mental illness and justifies people staying away from those with mental illnesses rather than helping them. On the other hand, Buddhism, the majority religion/philosophy in China, seeks to reduce mental health stigma. Buddhist beliefs could be the cause of the increase in demand for mental health care. The connections made are beneficial to understanding the root of mental health stigma and can be used in the future to combat the stigma and start increasing awareness and available mental health care.

Mental illness stigma as a moderator in the relationship between religiosity and help-seeking attitudes among Muslims from 16 Arab countries

BackgroundDetermining the potential barriers responsible for delaying access to care, and elucidating pathways to early intervention should be a priority, especially in Arab countries where mental health resources are limited. To the best of our knowledge, no previous studies have examined the relationship between religiosity, stigma and help-seeking in an Arab Muslim cultural background. Hence, we propose in the present study to test the moderating role of stigma toward mental illness in the relationship between religiosity and help-seeking attitudes among Muslim community people living in different Arab countries.MethodThe current survey is part of a large-scale multinational collaborative project (StIgma of Mental Problems in Arab CounTries [The IMPACT Project]). We carried-out a web-based cross-sectional, and multi-country study between June and November 2021. The final sample comprised 9782 Arab Muslim participants (mean age 29.67 ± 10.80 years, 77.1% females).ResultsBivariate analyses showed that less stigmatizing attitudes toward mental illness and higher religiosity levels were significantly associated with more favorable help-seeking attitudes. Moderation analyses revealed that the interaction religiosity by mental illness stigma was significantly associated with help-seeking attitudes (Beta = .005; p < .001); at low and moderate levels of stigma, higher religiosity was significantly associated with more favorable help-seeking attitudes.ConclusionOur findings preliminarily suggest that mental illness stigma is a modifiable individual factor that seems to strengthen the direct positive effect of religiosity on help-seeking attitudes. This provides potential insights on possible anti-stigma interventions that might help overcome reluctance to counseling in highly religious Arab Muslim communities.

Family members' experiences of courtesy stigma associated with mental illness.

The stigma of mental illness has been in existence from medieval times to date and it is extended to families of people diagnosed with mental illness. Families with a member diagnosed with a mental illness experience courtesy stigma of mental illness and it affects the quality of their lives. This study aimed to explore and describe the experiences of courtesy stigma of families with a member diagnosed with a mental illness in Lobatse, Botswana. The study was conducted at a psychiatric hospital in Lobatse, Botswana. A qualitative contextual phenomenological design was used for this study. The population comprised of members from families with a person diagnosed with a mental illness and the sample size was 15 participants. Semi-structured in-depth individual interviews were conducted telephonically. The study yielded three main themes and related subthemes. The themes were: families' experiences of received stigma, families' experiences of stigma by association, and families' experiences of internal stigma. Families with a member diagnosed with mental illness experience received stigma, associated stigma and internal stigma. The families experienced that they received dehumanising labels from the public because of their association with their mentally ill family members. With the insights gained from the findings of this study, programmes can be developed that raise awareness on stigma of mental illness and to promote support of families of people diagnosed with a mental illness.

The Relationship Between Religious Coping and Internalized Stigma Among Patients With Bipolar Disorder.

Stigmatization is a situation that results from the negative perspective of society towardindividuals with certain mental and physical illnesses and has negative effects. It has been observed that there are not enough studies in the literature investigating the attitudes of individuals with mental illness to cope with lifelong difficulties such as stigmaand especially their religious coping attitudes. However, there are many clinical studies on general psychology and religious coping with varying results. Our aim in this research is to reveal the association between religious coping and internal stigma among bipolar disorder patients. The religious coping scale and the Internalized Stigma in Mental Illness (ISMI) scale were administered to 79 patients with bipolar disorder. The obtained data were analyzed usingIBMSPSSStatistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States). Forty-two (53.1%) patients were female and 37 (46.9%) were male, the mean age was 43.41±12.57, and the mean follow-up period was 11.95±9.15 years.A positive correlation was found between negative religious coping and discrimination experience, alienation, and social withdrawal in bipolar disorder patients. A significant negative correlation was found between discrimination experience, alienation and social withdrawal, and positive religious coping. The correlation of religious coping attitudes with discrimination experience, alienation, and social withdrawal makes us think that religious coping methods may be one of the issues to be considered when dealing with self-stigma in bipolar disorder patients.In addition, the relationship between religious coping and self-stigmatization in mental illnesses can add a new dimension to psychosocial approaches. It would be beneficial for authors interested in religion and social psychology to focus on more extensive research on this subject.